3242 Black Oak Drn ?
f fIR .... t f?V F ?] I-fit: +y I,. #.?N ki i Nt}
;p?r?nnit 1?. ? t???
. . _ ? _ ? .
.?
,
ww
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:
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.
, _ .. .. _ ,
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WL ?
rdw
FOW Pft pft USPBCW - ikleW PIErber .
GwtaL ?r
E'ngrPlan
Bktq. Firtal
Deck F'tg.
t7eCk Finei
wen
Pr. L7lsp. ?
? ?? ?_ ?
I
il ? e 1?P
W.'emfica#e nf cccupanc4
This Cernificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the tvne of issuance tliis struciurr was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
SF I7WG 20981
use Classiecation: awg. e?,it xo.
R3/Ml R! VN CMSL
??g MARK 0F F?Q.IFd?IifiES A? 2779 75IA ST E, IQ3
?,:,
Budffm Addrm 3 vZHIOAK DRIVE ?Ty , B8, B[JR C1AK HIILS ?ID
Data
BWkfmg Officia?
POST IN A CaNSPK:UOU5 PLACE
Address 3242 N-ACK Oax D-RM Zip 5512 I
L,at' 3" Blk 8 Sub sUtt oAtt =s 2rID
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: Yes No Inspector:
Final gracie (6" from siding)
Permanent steps (garage)
Permanent steps (main entry) ?
Permanent driveway
Permanent gas L/
Soc€/Seeded grass
Trail/curb damage
Porch V/
Basement finish
Deck L Please vcrify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawss faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in righi-of-way or installing undergmund sprinkler system. ?
White - City Copy Ye1low - Resident Copy Pin?c - Contractor Copy
.... %. .. .. ..,.,_ /U (0 o -/
?
L 39819.1UL 261993
3
?
Request Date , Fire No.
1 Ro h-in Inspection
q
D Ready Now Will o Inspector
= No
9c, When Ready?
I >4tcun"sed contractor D owner hereby request inspection of above electrical work at:
Job Adtlress (Sireet. Box or Route No.)
? ? 611cK .? ?. City
leli,4?
Section No. Township Name or No. rnge No. Counry
Occupant(PRINT)
`,?K
??' PYk
`` C? Y6 ?
Power Supp6er
Y`? J ? I Address
Elettncal Contractor (Company me) ContractOr$ License No.
- KA ? o
Ma,in Addr s iContractor or Own r aking Instauation7
!/:j,,
Auth nze Signature ICoMractw%Ow aking tnstalla 1
Phone Number
_
?
? _1 VTl_ - 716
MINNESOTA SGTE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642•0800 ENCLOSED.
J U L 2 6 1993REQUEST FOR ELECTRICAL INSPECTION ea•oooo,•oe
//0
? ?? ?
See instructions tor complating this form on back of yellow copy.
819 "X" 8elow Work Covereci by This Request Iiip 3
ew Add fiepr! " Type of Building AppliancesWired EquipmentWired
Home Range Temporary 5ervice
Duplex Water Heater Electric Heating
Apt. Building Dryer OtheF-{Specity)
Comm./Industrial Furnace
Farm Air Conditioner
Other (Speaty) Contractor's Remarks
Compute /nspection Fee Below:
# Other Fee # Service Entrance Size FeQ; # CirouitslFeeders
Swimming Pool k 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps boyio- 109-?_ Amps
Signs Inspector5 Use Only: ? TOTALQ? ^/
Irrigation Booms ?' SU
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE OFISERED,? SeONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MOAI'?'FlS, f?, ?;
I, the Electricai Inspector, hereby
if
h Rou9n-in • ? oace _? f r??
y t
cert
at the above inspection has
been made. Final o e
OFFICE USE ONLY
This request void 18 months from
.... w w iwww
PERMIT
? GITzY OF' EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 881-4675
PERMlT TYPE:
Permit IVumber:
Date Issued:
u ING
020841
Q!b/08/43
SITE ADDRESS:
P . I . N . : 10-15501-090--08
DESCRIPTION:
Z:0:1
3242 sLAcK oAK aR
LQT: 3 BLOCK: 8
BUR QAK HILLS 2ND
Permit Type
>44,01rk Type
pa?t
ti?h -T
60
52
?'?a
? ?
a..»1 ?? , .
REMARKS:
S&W CONTRACI"OR - LAKESIDE PLUMBLlVG
FEE SUMMARY.
Ba6e Fee
Pian Review
Surcharge
SAC
SAC %
SAC Un.its
Lic. Search Fee
Sub tatal
$2,111.3.8
SF DW6
iV E W
R-3 M-1
VN
R-1
$140,0ee
MISC FEES
CUPY
Total Fee
$1,7Q4.54f
1.50
$3,856.18
s't M ?wFe! SuP.SA' '.4ll??J Si-:-V LagV(R{ nM11*P?? F . .'. t?
?
--
APPLICANT/PERMITEE SIGNATURE ISSUED Y: 91GNATURE
vALuarraN
$i79.5@
$506.68
$70.00
$750.00
10e
1
$5.00
/
REACTIYRTE
PERMIY t
?
C1TY OF EAGAN ??'°= r. ?
1993 BUtLDI?VG PERMIT AP ??;?'D
681-4675 A PR 2 9 193
___ V3
SINGLE & MULTI-FAMILY 2 sets of pians, 3 registered site surveys, 1 copy of energy
cal cs .
COMMERCIAL 2 sets of architectural & structural plans, I set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit i5 typed, but not picked up by last warking day of month-
in which request is made, 2} address is changed or 3) lot change is requested once permit
is issued.
Qate Val uat i on af work 1Z5ca 0
Site Address: Dr21-
. S7REE! SUITE 0
Tenant Name: (commercial only)
IAT BIACK ? SUBD.
Descri tion of work: ??4u 1?6}me-
The appl i cant i s: E7 Qwner 14 Contrattor 0 Othe1' (DesGriee)
Name ?Siznr_..? ?? ??-??f??,?n. ? Phone ?z/- 3s ??
Property `AsT FIRST
Owner Address a?po rL ; `?. ?-3ob
STREET STE N
City 606_?I.; State M_x) Z i p
Company /?41zlz Phone ???r
Gontractor Address ???? ?STH :5.,.e,i- L;cense #,66660,9,7 Exa.?_
City State M P--? Z i p
Company Phone
14rChftect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is twa days ance area has been approved'.
I hereby acknowledge that I have read this applicatiQn and state that the informatian is
carrect and agree to comply with all applicable State of Minnesota Statutes and City af
Eagan Ordinances. .
? ??
Signature of Applicant:
OFFICE USE C3NLY ,
BUILDING PERMrT TYPE O OI Foundation E3 45 Duplex ? 11 Apt./Ladging ? 16 Basement Finish
13r 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swsm Roal
? 03 SF Addition Q 08 8-Rlex ? 13 Garage/Accessary ? #.8 Comm./Ind.
D 04 SF Porch a 09 12-Rlex ? 14 Fireplace ? 19 Canm./Ind. Misc.
? 05 SF Misc. 13 10 Multi. Addll. ? 15 Deck ? 20 Public Facility
CI 21 Miscellaneous
W4RK TYPE
A 31 New ? 33 Aiterations ? 35 tenant Finish ? 37 t}emolish
? 32 Addition ? 34 Repair O 36 Mave
GENERAL INF QRMATiON ,
Gonst. (Actual) v- M Basement sq. ft. MIWCC System YES
(Allowable) v- lst F1. sq. ft. City ?later ?
UBC Occupancy -? 2nd F1. sq. ft. PRY Required
Zoning R_1 Sq. Ft. total Booster Pu?np
# of Stories- Footprint Sq. ft. Fire 5prinkler
Length 60 On-site well Gensus CQde
Depth g2. On-site sewage SAd?1?' _L
?
APPROVALS
Pianning Building Assessments
Engineering Variance
REQUIRED INSPECTlONS
O Site
D Wallboard
? Faoting
? Final
? Framing
? Draintile
Cl Insulation
? Fireplace
Permit Fee v?luacion: & Iy0 , t??? ?
Surchar9e
Pl an Rev i ew Zr.,'D 17LLY0 p-
License
MW
AC ?-- ? x t2. = (zy?
- 79
CC 5
city sAc
??? ???je?? Z
???x I ??r?, ,?
.,.
Water Gonn. I?sr?T; '76q x/? 2 ?cf?'x'?- ?v
Water Meter . ?- -- --
Acct. Deposit Z2x :36 =?92 geqx 5Y=
S/W Permit
5/W Surcharge
??7, x F "-
4 41 Z26?
.-- .
i'reatment P1.
Road Urt i t '?32 x1s= ? ---
Z9 `z-
139
Park Ded, ,
Trails Ded. 2y ?C 30 ? -?2o
Copies 7=
Other
Total :
SAC %
SAC Units 7 d _ ..._? •
?
u nrr?.-!?-?,?r°?? ?r1 .
-
??xr'?(? 38yZc? ,6?
K
-• ?
." • , ' •
., .
' • k;YTL•'IdiOlt F.NVL[AP1; AVI:INGE ••U•` CQ:4['U'i'ATION
?
r,w??r•,?t __ -
si•rL nDniu:ss LoT 3, SLOr? ?RuJZ-e OAk PIcL5. ZA,b Abuizzor.r r
? caNTR+crorr ,..b_&4 OF x?- __ •i???? 3?.4/? /?- - - -
DATe
Deterrt?ine Working square Eoatage of eacli.
2. Total exposed uall arc:a .........!?? ft. x
2. Total roof.ceilinq area ...... _/?c? Y•0 -Sy. Et. x .025 a .??• ?
Total exposed wall area above Eloor
.•
a. Total walg window area . . . . . . . . . . . . . . . . . . . . . . . . . . . • . • . . . #e
b. Total doar acea ........................................... c. Total siiding giass door'area .............................
ij. Total Cireplace wail area ................................. - ?
e. Total wall Eraming area (average lDt) .....................
f. Total net wall area abave fl.oor ...........................
. g. Total rim joist area ...................................... .
Total exposcd Eoundation arca
?
h. Total Coundation window area................................
i. Total net founuation area above gradc :... ...............•. ??Q•? -
petermine °U" valuc of each waxl segment.
XOU.. `,
a. •
x nVH -&Ny(???Li JI? .. .
• D
C x .1uN . ? 3 O .
C.
d. 0 X '6u..
. _ •
RUp ?! ?` _ ??? •
cA. /y
s._???•D x Hua.
'?•???=?'--•-?- x U. ` . ..__ .. ??
3 .................... .............-...T" tal
If itein M1 is tl?a sarnc as, or Lcs:; tlwit item NL. yaie h.tivu m.et r:hc i,nt4nt?
o[ 5BC GOOf, (c) 2 .b&u 4- / 3?)
4:, 0 0 & (C? a
Total exposec3 roaE/ceiliny area = /'?r?f?? ? ?_
j. TQtal skylight area ....................................... 0
k. 1btal root/Ceiliny Eraminy arc;a iavecacje it)'wa ..... .... .... e?E2•
1. Total nct insulatcd roof/ceiliric) area ..................... /. ?
Detvrmine "U" valua for cach rao€/eciLiny seynent.
..
x..u„,_ a = D
k. /3?• i? x "u..
x Mu., 7_
4 ............................ . ......Total = ??j?'•D
If total af 14 is the same as, ar less than 12, you have met the intent of
58C 6006 (01. ?/ ??. D,? G. ?3 0't.p_ °'`-&,f .
Alternate 8uildinq Envelape [lesign
To utilize the tatal enveldQe systern meChocl, the valties rstablish•.!d hy the
su,y? of items R3 and 14 shall not be greater than the surn vf itemy K1 and 03-
1. + 2. ' „? • ,? = o?? •, , .
.3. . 2 oS. 3 + 4 .
. ? • ? ?. - . •?;??
. : .?b?. .d'`•?t? '? y` . ? . ; .,
. , : .. j
. . ,
. .:;.,
.? ?x ?....._._.
4 4 ?
?Q?? `?iA?W?ns ndaiAND siuAYeYoAs
p IENGINEERING
CaMPRNY, iNC.
1000 EAST 1481h BYREET,
?yfq,p,? a? ExcE?CE
110'J'lE ?fd/Cd0S iRe• ?
2
M. Z9 ?
BURNSVILLE, I+IINN€sOTA 5533l Pli 432'3000
CERTlFICATE OF SURVEY
Legal DeSCI'lptlOn: LOT 3?__OLcCu_ .._ YALI. 2ti_I2 ,qt?t?lrIo?cJ.
D 7'.4 C.ovd17Y^Mt A.J n?cSn-re ?
( a fl,-o ) DCNOTES EXISTING ELEVATION
{ W. S ) DENQTES PRQPOSED ELEVATION
,_,.----- INDICATES DIREGTIQN OF SURFAGE DRAINAGE
898. 3=FINISHED CAAAGE FLOOa ELEVATION
89/, - 9ASEMENT FLOUN ELEVATION
'1. 3= TOP OF FC?UNDATION ELEVA'f iON
sCALE: 4' - 30' X-/wGH/V,E'< ' TNW cO L3-L4, B R. EGEI/, = 897.9,0
34 FT. APANT 9v/LPlrt/'6
$ETj,WGk 41IVE
i
30. oo `.? • f t t
n
($95? ?ug= 8q5.95? ?g9 S t? ? ? [qoo,3?
(D2i.s7 /45.67 ra9?.?? ??oa,-3,
+n
? ` s,s g zb.33 . $ ,?96l?? ? •. \? _
r .-
? z4.ara
q ?.? o ? 8 Q f _'C I ?v
y, ?v
N Zz,ao Ig ? o
`?9. `
10
Ul
;? ?, _._._- _ ..--- = • r?p3,??
?8`0/? ??76.,? C?so, ?3 I 0 /53, 67c?r7,b? ?97.-?? o
?, ?
(89b,15 jr/ q9° 511 4-$'C .
/LrT Y ?'.9.5'EM,
-,,??.wr,.. _
?"' ] ? .
X_,?.?:I,?,?'? ??::r?NE??:? ? I???=•??`
T
I hereby cortif lY?revn. correct i? o2 ?, trd?y o?
land as shawn
AP9IC r 1 g 93
• ,
?.. ? .
Minn. Reg. No. 4,0
J
ca N
4 >
ui
?
Cd
w J
? m
cn
?
4
z
D
2
LQT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEf3AL:
DOCUMENT STANDARDS
/ f '
Date of Survey:
BI? o • Registered Land Surveyor signature and company
2"11 ? • Building Fermit Appl.icant
0'-o0 11 • Leqal description
? CY`0 - Address
iroo'? 0 • North arrow and bar scale
oe''M 0 • Hause type (rambler, walkout, split w/o, split entry,
lookaut, etc.)
I'?l7 ? • Da.rectional drainage arrows with slope/gradient ?.
0 Gi-''? • proposed/existing sewer and water services
Ci'' 0 0 • Street name
0''-L7 ? • Driveway
ELEVATiaNs
Existinct
D Ce'0 •
* sewer service
? 0 •
d Lat corners
?? ? • Top af curb at the driveway
C!r ?? • Elevations of any existing adjacent homes
Proposed
?0 ? • Garage floor
? C] ? • First floar
Lowest exposed elevation (walkaut/window)
,0' C] ? • Praperty carners
,0- 0 0 • Front and rear af home at the foundatian
PONDxNG AREAS (if apnTioable)
? ? ? •
? ? ? • Easement line
NWL
? ? ? • HWL
? ? 0 • Pond # designation
? 0 • Emergency Overflow Elevation
DIMENSIONS
0'?0 0 • Lot lines
?? ? •
? Right-af-way and street width (to back of curb)
L
0? • Praposed hvme dimensians including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
Q?? ? • Show all easements of recoxd and any City utilities within
?? ? those easements
tb
k
f
d
t
• o
a
jacen
Setbacks of proposed structure and se
ac
?? • existing
Retain?yrfj??? r irements, if any
Reviewed
na
October 1992
*
1993 PLUMBING PERMIT (RESIDENTIAL)
CITY OF FAGAN
3830 PILOT KNOB RD
EAGAN MN SS122
(612) 6814675
FLEASE GQMPLETE FQR SINGLE FAMILY DWELLINGS. ALS4, F4R T4WNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EAGH UN1T•
NO. FIXTLTRES
loz SHOWER
3 WATER CL4SET
?- BATH TUB
? LAVATORY
KITCHEN SINK
LAUNDRY TRAY
HOT TUB/5FA
WATER HEATER
/ FLOOR DRAIN
GAS PIPING QUTLET • minimum -1
3_ ROUGH 4PENINGS
WATER SQFTENER
PRIVATE DISP. • nak.ety. uc.
U.G. SPRINKLER • nome under const.
ALTERATIONS • co ?cing
WATER '1`L.7RN AROUND
STATE SURCHARGE
TOTAL:
EAGH
3.00
3.Q(1 ? . w
3.0(! ? . w
3.00
3.00
3.00 ,3 ,sJ
3.00
3.00
3.(j0
3.t}0 ;3 . ?.v
1.50 '?• S?
5,00
15.00
3.00
15.00
15.00
.50
,Sr3 . uv
SITE ADURrS5:_ 3,)'Y aZ "3 ?-re- K o r4Jc- a v2
OWNER NAME: /J-2VAoC
INSTALLER: 1-IXe5 itJ e- o'.AIJ G
.d.DDRESS-,_„ /ar y6 ? ??/ ?^? 4&'e- s `a -
CITY: STATE: ? ? . . ZIP GODE: •??`.???
PHONE #: (G/') )
SIGN URE OF PERM EE
0- jr. ,
1993 PLUMBING FER,MIT (COMMERCIAI.)
CITY UF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
FLEASE COMPLETE FOR ALL CQMMERCIALJINDLISTRL4L BUILDTNGS. ALS4 FOR MULTI-
FAMILY BUII.DINGS WHEN SEPARATE PERMITS ARE NOT REQUIREI] FOR EACH
DWELLING UNIT.
NEW CQNSTRUGTION
ADD ON
REPAIR
WOl2K DESCRIFI7ON:
CON'I'RACT PRICE: ?
FEE: 1% OF GONTRACT FEE.
STATE SURCHARGE: $.50 FOR EACH $1,000 OF .`... ?!.....` _.. ? FF,E.
_ ... .. ....... :
MINIMUM FEE: $ 25.00
CONTRACT PRICE X 1% $
STATE SURCHARGE $
T4TAL $
SI'I'E ADI?RESS:
TENANT NAME: STE. #
UWNER NAME:
INSTALLER:
ADDRESS:
CITY: STATE: ZIP CUIyE:
PHONE #:
FQR:
Cl'1'Y OF EAGAN APPLICANT
PLEASE C4MPLETE FOR SINGLE FAMII.Y DWELLTNGS. ALSO, FOR T4WNHaMFS AND
C4ND05 WHEN PERMITS ARE REQUiREI? FOR EACH UNTT.
x NEW C4NSTRUCTIQN
ADD-ox A/e
? ADD-ON FURNACE
DATE 7r7i9s
HVAC: 0-100 M BTU
ADDITIONAL 50 M $TU
GAS QUTLETS (MINIMt]M 1@$3.OQ EACH) (4)
(RANGE, DRYER, FIREPLACE, FURNACE)
ADD-dNIREMODEL (EXISTING CONSTRUCTiON)
STATE SURCHARGE
TOTf1L
FEES
$ 24.00
6.00
12.00
$ 15.00
.50
36. 50
STTE ADDRESS: 3242 BLACK OAK DRIVE
OW-IrTER NAIvIE: MARK OF EXCELLENCE HQME BLDRS.TFJXPHaNE #: 450-0867
INSTALLER: METRO AIR, Inrc .
ADDRESS: 16980 wELCOME AvE. sE.
CIT"Y: P R I O R LAK E,, STATE: MN. ZIF CODE: 5 5 3 7 2
TELEPHONE #: 447-8124 -
Q7,4,4?-. --- - -
SI NATiJRE aF P
1993 MECHATIIGAI. FERNIIT (RESIDENTiAL)
CITY OF EAGAN
3830 PILC)T KNOB RD
EAGAN MN 55122
(612) 681-4675
-?r--, s` _ e
1993 MECHANICAL P'ERMIT (CUMMERCIAL)
CITY OF EAGAN
3830 PILO"T KNAB RD
E.AGAN MN 55I22
(612) 6814675
PLEASE CQMPLETE FOR ALL COMMRCW-ANDUSTRLAL BUILDiN+GrS. ALSC) GOMFLETE
F(3R APARTMENT BUILDINGS OR 4THER MLJL'I'I-FAMILY B[IILDINGS WHEN SEPARATE
PERMTTS ARE NOT RE4UIRED FOR EACH DWELLING iJNIT.
._________.?...........__.___..??..__?_.._._.?._..?.r...?........
DATE: CONTItACT PFLICE: $
NEW BUILDING INTERIaR IMPR4VEMENT WORK DESCRIFTION:
FEES
1% fJF ?????»:;<:.?>.:;:::.;?.:::::;:_:_.?_. '! FEE $
..:;,
PROCE55ED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 F(7R EACH $1,000 OF FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPH4NE #:
TENANT NAME: (IMPRUVENIENTS ONLY)
INSTAI.LER:
ADDRFSS:
CITY: S'I'ATE: ZIP CUDE:
TELEPH4NE #:
SIGNATURE (aF PERMITTEE CTTY INSPECTOR
Altera'tbn6 tp wdst! vrink um be
Deudte: .G:f
B8th tIJII
Fi00i dP8ln
Gft E 111 G" " miniPrwrn - 4
HO't tIJb/S " .00 ; 1
it144When sIF1k ' . . .
"
, 100
. x
A.,-?
LaUnd " . . . . . . .VV . X , - -?
3y0 ?R Th y t
. .. ,.
Se C stern
mwrMufbbw, "m4o#upe NV.
I?t 0 . ..
: x
; .
v. ?
e
T . " .
?t?C17 AbgndOnment w
x
sx
: ..
-
RPZ WA[ lns"a'#??? bYWAd1 ? 00.
RO h G eF1111 1,50 - X : . . ? ? _ .
Shawer 3,w
U!1 iYlUCICI $ f1l1kle? ?*mwl t5 W1xdw CQriatPUCtio1 x .
Un round r?kler impotwg ` dwNhr?? 30 :t?- x
Water cbset 3:00
Water Iteater . ' X = ? ? . .? .
Water saftsner . l1 d!?ut? Ar+dw 48"MikMon x
U1mter soflener I# e?
J ??14 x
.. ,
?
Waber tumaround x
SAwe Surcharge
?
ToUl
-? .
, -?? .
--? . .
-?
:? `': .. ..
` - '
.
RmIlfder: CWl for !? of-eWwaftm;` i.&: wow`hNA&M w4w , f*.,#*:4
.
c1TY: - %ll1 aa El 5'TATE
. ?:
. .?
?MA'fUF*,004 kefoom
? t
A?9 C"6 `l
2007 RESIDENTIAL BMDING PERNII'F APPLICATION
City Uf Eagan
3834 Pilot Knob Road, Eagan MN 55122
Telephone # 551-675-5675 FAX # 651-675-5694
New Construc6on Reauiremenls
3 regis#ered srte surveys showing sq, ft, of lot, sq. ft. of house; and zlI roofed areas
(20% rnaximum fot coverage aflawed)
1 Soils Report if pr4posed huilding is ta be placed on dislurbed soil
2 eopies of plan showing Deam & wiRdow sizes; patred taund design, elc.
1 secof Energy Calcu4atians
3 copies of Tree Preservation Plen i( lot pfatted afler 7i1193
Fiim Joist Detail Options selec6on sheet (buildings with 3 or less units)
Minnegasco mechanical venblaaon farm
Plans are considered
Date 7 1 ? /
Si#e Address
(?'?' o- c
RemodeVReoair Reauirements 0#fice Use..0 nk
2 wpies of plan showing tootings, 6eams, jaisls CeltnfSu(vey Rpcd `. -Y '-.N
1 sel of Energy Ca[culations iar healed addibons Soas RePod N
1 site survey for addidons & dedcs Tree Pres PfanRed : Y=R
Addifian •)rdcate rf ort•site sepGc system 7ree Ptes Requu'?i Y? N
Oa-s? SeptlC 5yst?m ..:_ Y; -: N
ic information unless au state the are trade s?cret and the reasan,
Consteuction Cost
Unit/Ste #
Description of Work
Multi-Family Bldg - Y _L1 N
Fireplace(s) _ 0 _ 1 - Z
Property Owner r Telephone # ?-?-
0 ;2- J G/, il% 0- v
Contractor
Address Cfty
State Zip T ') T Telephone #
COMPLETE TH1S AREA ONLY 1F CONSTRUCTINC A NEW BUILDING
-- Minnesota Rules 7670 Cate or 1 ? Mj??esota Rules 7672
Energy Cade Category 0 Residentsal Ventilatian Categary 7 Worksheet • New Energy Code Worksheef
(4 submission type) Submitted Su6mitted
. Energy Envelope Calculations SubmiYted
In the last 12 months, has ihe City of Eagan issued a permit for a similar p6an based on a master plan?
Y _ N if yes, date and address of mastef plan:
Licensed Plumber
Mechanical Confiractor
Sewer/Water Contractor
Telephone # (
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is eomplete and accurate;
that the work will be in eonforrnance with the ordinances and codes of the City af Eagan and the State of MN
Statutes; I understand this is not a perrnit, but only an application for a permit, and work is not tcs start without a
perrnit; that the work wil] be in accordance with the approved plar? in the case of work which requires a review and
approval af plans.
A
Applacant's Printed Name icant's Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvnes
? 01 Foundation
? 42 SF Dwe[ling
? 43 01 of _ plex
? 04 02-plex
? 05 03-plex
0 06 p4-plex
0 07 05-plex
? 08 06-plex
? 09 A7-plex
? 10 08-pfex
? 1/ 10-pEex
CI 12 12-pEex
? 13 16-plex
13 16 Fireplace
? 17 Garage
? 18 Qedc
? 19 Lower Level
? 20 Pool ? 30 Access.oryBldg
? 21 Poroh (3-sea.) ? 31 Exk. Alt- Multi
0 22 PorchlAddn. (4sea.) 0 33 Ex#. Alt - SF
C] 23 Porch (screenlgazebolpergola) ? 36 Mulfi Misc.
? 24 Storm damage
? 26 Miscellaneaus
Work Tvoes
G 31 hlew
? 32 AdrJitian
? 33 Alteration
0 34 Replacement
0 35 In# lmpravemeM ? 38 Demolish Interior 0 44 5iding
? 36 Move Buiiding ? 42 Demolish Foundatian ? 45 Fire Repair ? 37 Demalish Building" ? 43 Reroaf ? 48 Windows/Doors
*Demnlution (Entire Bldg) - Give PCA handout to applicant
Description: WaterDamage Yes
Valuation C?ccupancy MCES System
Plan Review 100% or 25%
Census Code Zoning Cify Water
SAC llnits Stories Booster Pump
# of llnits $q. F#. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Wdth .
REQUMD IlVSPECTI4NS
_ Footings (new bldg) _ Sheetrock
_ Footings (deck) v FinallC.O.
_ Footings (addition) - Final/No C.O.
Foundation HVA C
Drain Tile Qther
Roof
Ice & Water Final Pool. Ftgs _ AirlGas Tests Final
_
_
_ Framing _
_ Siding _ Stucco Lath _ Stane Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee .
Surcharge
Plan Review
MClES SAC
City SAC
Utifity Connection Charge .
S&W Permit & 5uroharge
7reatment Rlant
License Search
Copies
• Other
Total _
?
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA108768
Date Issued:01/09/2013
Permit Category:ePermit
Site Address: 3242 Black Oak Dr
Lot:3 Block: 8 Addition: Bur Oak Hills 2nd
PID:10-15501-08-030
Use:
Description:
Sub Type:e - Furnace & Air Conditioner
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector, (952)
445-2840
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
James L Feely
3242 Black Oak Dr
Eagan MN 55122
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140211
Date Issued:12/01/2016
Permit Category:ePermit
Site Address: 3242 Black Oak Dr
Lot:3 Block: 8 Addition: Bur Oak Hills 2nd
PID:10-15501-08-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
James L Feely
3242 Black Oak Dr
Eagan MN 55122
(651) 325-8442
Property Claim Solutions LLC
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA142328
Date Issued:04/26/2017
Permit Category:ePermit
Site Address: 3242 Black Oak Dr
Lot:3 Block: 8 Addition: Bur Oak Hills 2nd
PID:10-15501-08-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
James L Feely
3242 Black Oak Dr
Eagan MN 55122
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA145911
Date Issued:09/28/2017
Permit Category:ePermit
Site Address: 3242 Black Oak Dr
Lot:3 Block: 8 Addition: Bur Oak Hills 2nd
PID:10-15501-08-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
James L Feely
3242 Black Oak Dr
Eagan MN 55122
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA165836
Date Issued:11/23/2020
Permit Category:ePermit
Site Address: 3242 Black Oak Dr
Lot:3 Block: 8 Addition: Bur Oak Hills 2nd
PID:10-15501-08-030
Use:
Description:
Sub Type:Reroof & Windows/Doors
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Windows/Doors: If altering the opening size, a framing inspection is required.
Valuation: 10,000.00
Fee Summary:BL - Base Fee $10K $191.75 0801.4085
Surcharge - Based on Valuation $10K $5.00 9001.2195
$196.75 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Diane Lynn Feely Living Trust
3242 Black Oak Dr
Saint Paul MN 55121
Guardian Services Contracting
1042 20th Ave N
South St Paul MN 55075
(800) 617-8450
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168071
Date Issued:04/08/2021
Permit Category:ePermit
Site Address: 3242 Black Oak Dr
Lot:3 Block: 8 Addition: Bur Oak Hills 2nd
PID:10-15501-08-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Diane Lynn Feely
3242 Black Oak Dr
Eagan MN 55121
(651) 325-8442
Lindus Construction
879 Hwy 63
Baldwin WI 54002
(715) 684-4647
Applicant/Permitee: Signature Issued By: Signature